Health psychology (option): personality, Type A and stress

Type A and Type B

Cardiologists Friedman and Rosenman described the Type A behaviour pattern in 1959:

• Competitive and achievement-driven.
• Time urgency and impatience.
• Hostility: easily angered.

Type B is relaxed, patient and less competitive. The two are best seen as ends of a continuum.

Type A people may experience more stressors (taking on too much) and react more strongly (more sympathetic arousal), raising blood pressure and heart disease risk.

The Western Collaborative Group Study

• 3,154 healthy employed men aged 39 to 59 from ten Californian companies, followed for 8.5 years.
• Classified as Type A (1,589) or Type B (1,565) from a questionnaire and their observed manner.
• Findings: Type A men developed coronary heart disease (CHD) at more than twice the rate of Type B men, even after controlling for smoking and lifestyle. Of the 257 men who developed CHD, 70% were Type A.
• Later research: a 22-year follow-up (Ragland and Brand, 1988) found Type A men who had already had a heart attack were actually less likely to die than Type B men; and research narrowed the risk to hostility rather than the whole pattern.

Other traits and evaluation

• Hardiness (Kobasa): commitment, control and challenge; hardy people see stressors as challenges and appear to suffer fewer stress-related illnesses.
• Traits such as neuroticism (anxious, emotionally unstable) are linked to stronger stress responses.

Evaluation:

• Strengths: large, longitudinal, prospective study (WCGS) that controlled other risk factors; practical application (anger management for high-hostility patients).
• Weaknesses: men only (gender bias, limited generalisability); middle-aged American workers (culture); 'types' oversimplify continuous traits; later findings were inconsistent, pointing to hostility only; classification depended on judgement of manner (some subjectivity); correlational.

Worked example

Of the 257 WCGS men who developed CHD, 70% were Type A. About how many is that?

1. 0.70 x 257 = 179.9.
2. So about 180 men with CHD were Type A.

Answer: About 180 men.

Check yourself

1. Which is a characteristic of Type A behaviour?
   • Time urgency and impatience
   • Relaxed and easy-going
   • Low competitiveness
   • Rarely angry
   Show answer

   Time urgency and impatience. Time urgency, competitiveness and hostility.

2. How many men took part in the Western Collaborative Group Study?
   Show answer

   3154. 3,154 men.

3. For how many years were the WCGS men followed up in the original study? Give your answer to 1 decimal place.
   Show answer

   8.5. 8.5 years.

4. In the WCGS, 1,589 of 3,154 men were classed as Type A. What percentage is that? Give your answer to 1 decimal place.
   Show answer

   50.4 %. 1,589 / 3,154 x 100 = 50.4%.

5. Later research suggested which part of Type A is most linked to heart disease?
   • Competitiveness
   • Hostility
   • Time urgency
   • Working long hours
   Show answer

   Hostility. Hostility predicted CHD.

6. Which three Cs make up hardiness?
   • Competition, control and coping
   • Calm, care and commitment
   • Challenge, cortisol and control
   • Commitment, control and challenge
   Show answer

   Commitment, control and challenge. Kobasa's hardy personality.

7. Explain one weakness of the Western Collaborative Group Study.
   Show answer

   It only studied middle-aged American men, so the findings may not generalise to women or people from other cultures.. Sample and consequence.

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Sources

• Pearson Edexcel International Advanced Subsidiary/Advanced Level in Psychology specification, Issue 6 (November 2024, first assessment January 2026)
• Rosenman, Brand, Jenkins, Friedman, Straus and Wurm (1975), Coronary heart disease in the Western Collaborative Group Study: final follow-up experience of 8 1/2 years, JAMA 233 (PubMed)

Last updated 8 November 2026. Spotted a mistake? Tell us.